One Thousand Ears in 7 years-A Single Surgeon's Experience of Performing Otoplasty and Cosmetic Ear Surgery in Adults.

The majority of the literature contains outcomes of paediatric otoplasty with multiple surgeons' outcomes. However, to date, a single surgeon's case series numbering over 1000 adult cases in the same center has not been published. Cosmetic ear surgery in adults requires a completely different approach compared with children for the operating surgeon regarding assessment and technique. This paper shares the experience and lessons learned by the author who is a specialist in ear reconstruction and cosmetic ear surgery including patient selection, operative technique and postoperative care. Adult patients (age 18 y and over) were consulted by the author between September 2018 and June 2025. Patients presented with prominent ears, scapha and / earlobe hypertrophy, lop ears, Darwin's tubercles, split earlobes, tribal earlobes, and keloids on the ear. Results included correction of bilateral prominent ears in 216 patients (432 ears), Bilateral split earlobe repair in 226 patient (452 ears), Keloid debulking in 66 patients (66 ears), single prominent ears in 26 patients (26 ears), earlobe reduction in 31 patients (62 ears), scapha reduction in 24 patients (52 ears), Stahl's ear correction in 8 patients (8 ears), bilateral tribal earlobe repair in 10 patients (20 ears), lop ear correction with cartilage grafts in 8 patients (8 ears), and Darwin's tubercle excision in 5 patients (5 ears). A total of 1131 ears in 662 patients were treated during this time period. In the author's experience, the history including psychological assessment of patients suitable for cosmetic ear surgery is the hardest yet most important part of the process. Any misalignment between patient provider perception and expectation should be questioned until both patient and provider are aligned with clearly defined goals.